Royal College of Paediatrics and Child Health

Paper One B Web Specimen Paper - Answer Key

Question
Number Answer Key Answer and Description
Extended Matching

F Microdeletion
D Chromosomal
1 B Autosomal dominant
J Slipped upper femoral epiphysis
D Juvenile idiopathic arthritis
2 H Reactive arthritis
B Ice pack on the face
A Defibrillation
3 I Radiofrequency ablation
I Sodium valproate
D Explanation and reassurance
4 D Explanation and reassurance
A Coagulase negative staphylococcus
F Proteus vulgaris
5 C Group A streptococcus
F Obstructive sleep apnoea
J Vascular ring
6 A Choanal atresia
F Hypernatraemic dehydration
E G6PD deficiency
7 D Galactosaemia
C Infectious mononucleosis
D Kawasaki disease
8 B Enterovirus infection
G HUS
E Crohn’s disease
9 C Colonic polyp
I Short synachthen test
A Bronchoscopy
10 J Ultrasound of chest
D HbE/β thalassaemia major
J Sickle cell anaemia
11 C G6PD deficiency
F Crohn’s disease
I Lymphoma
12 A Anorexia nervosa

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 Royal College of Paediatrics and Child Health

Multiple True/False
has a recognized association with inflammatory bowel disease
13 C E is associated with the use of oral contraceptives
nutritional rickets
14 D E vitamin K deficiency
Down’s syndrome
15 A C myotonic dystrophy
gonadectomy is indicated in androgen insensitivity syndrome (testicular feminization ) after puberty
hydrocolpos results from an anomaly of the Mullerian system
16 A B E ultrasound is the most appropriate initial investigation in a baby with bilateral undescended testes
acute toxicity is potentially fatal
it induces release of serotonin from nerve terminals
it is an amphetamine derivative
17 A B C
Fractional excretion of sodium of 0.8% (low)
Urine / plasma urea ratio of 15 (high)

18 AC

predict lung maturity

predict the severity of rhesus haemolytic disease
19 D E
lesions of the cortico-spinal fibres result in ipsilateral defects
20 A E trauma to the cervical cord typically causes urinary retention
Defects of mitochondria disrupt oxidative phosphorylation
Mitochondria proliferate in response to energy requirements
Mitochondrial genes are heteroplasmic
21 A C D
delayed language development
having a sibling with cerebral palsy
22 B C

IgM is the first immunoglobulin to be made by the fetus

Levels of C3 complement decrease after streptococcal nephritis
23 C D

Erythromycin and carbamazepine

Lamotrigine and sodium valproate

24 B E
Bartter’s syndrome
pyloric stenosis
type 1 (distal) renal tubular acidosis
25 A D E

achalasia of the cardia

gastro-oesophageal reflux
measles
26 A C D E pertussis

maternal short stature

residence in inner cities
27 B D

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 Royal College of Paediatrics and Child Health

Best of Five
28 C Tetralogy of Fallot
29 C EEG
30 B Lung hypoplasia
31 A Eye examination
32 D Creatinine
33 A CT
34 A 6 attacks
35 D Restrictive lung disease
36 B Autistic spectrum disorder
37 C Maternal Kleihauer test for fetal haemoglobin
38 E X-ray of wrist
39 C Intracranial tumour
40 E Hirschprung’s disease
41 A Chromosome abnormality
42 C Intoxication
43 E Urinary VMA and HVA
44 D Marfan’s syndrome
45 A Ingestion of aspirin
46 E Retinal haemorrhages
47 C Long Q-T syndrome
48 E Repeat nebulized salbutamol
49 E PDA
50 D Streptococcus pneumonia
51 B Enthesitis-related arthritis
52 E Observation only
53 E Spinal muscular atrophy
54 A Chronic glomerulonephritis
55 C Oral isotretinoin
56 C Thyroid stimulating immunoglobulin
57 D Prolonged glucose tolerance test
58 A Give chemoprophylaxis with isoniazid and rifampicin for 3 months
59 C Chronic hepatitis B carrier (low infectivity)
60 C Karyotype
61 E X-ray of hips
62 C Nightmares
63 C Referral to a paediatric ophthalmologist
64 A 0.9% sodium chloride
65 E Start oral diuretic therapy
66 D Spastic diplegia
67 A Agree not to treat unless fit frequency increases
68 E Vitamin K deficiency bleeding
69 B Ask a nurse to telephone the Police
70 B Izoniazid
71 E UTI
72 C IgA nephropathy
73 A Atypical mycobacterial infection
74 C Lamotrigine
75 D Short syncthen test

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Registered Charity 1057744 Tel: (020) 7 307 5600 Fax: (020) 7 307 5601 E-mail: enquiries@rcpch.ac.uk Website: www.rcpch.ac.uk